التفاصيل البيبلوغرافية
| العنوان: |
Perioperative anaphylaxis in children: Etiology, time sequence, and patterns of clinical reactivity. |
| المؤلفون: |
Khaleva, Ekaterina, Franz, Amber, Garvey, Lene Heise, Jay, Nicola, Ylescupidez, Alyssa, Bahnson, Henry T., Toit, George, Atanaskovic‐Markovic, Marina |
| المصدر: |
Pediatric Allergy & Immunology; Jan2020, Vol. 31 Issue 1, p85-94, 10p |
| مصطلحات موضوعية: |
ANAPHYLAXIS, ETIOLOGY of diseases, SYMPTOMS, CARDIAC arrest, ADRENALINE |
| مستخلص: |
Background: Perioperative anaphylaxis (PA) in children is an uncommon but potentially life‐threatening complication associated with anesthesia. Early identification and management of PA is essential to optimize clinical outcomes. Methods: We performed a retrospective study of anesthesia records from pediatric patients with PA from centers in the United Kingdom, France, and the United States over a period of 10 years. Time sequence of clinical signs and physiological variables during PA were collected, along with results of allergy testing. Results: Twenty‐nine children with PA were included. Median age was 11 years. Based on the modified Ring and Messmer Grading Scale, severe reactions were seen in 25 (86%) members of this cohort, with 4 (14%) experiencing cardiac arrest. Life‐threatening hypotension was the first clinical sign of PA in 59% of cases, followed by tachycardia and bronchospasm. In 16 (55%) cases, the initial signs of PA involved multiple organ systems. When the initial signs of PA were cardiovascular and/or respiratory, more epinephrine doses were administered. Average time from initial sign of PA to treatment with epinephrine was 6 minutes (SD: 6, range: 1‐25). The causative allergen was identified in 15 patients. Conclusion: Severe hypotension is the most common presenting sign of PA in children. Initial cardiovascular and/or respiratory signs are associated with the need for increased epinephrine doses. Further studies should optimize the prediction, identification, and early management of PA in children. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
